Vernon Leigh – Regained confidence with a C-Leg

Seventy-four year old above-the-knee amputee Vernon Leigh shares his journey of obtaining a new prosthesis, which the feels has re-energised his life.

“When I was aged nine, I was diagnosed with polio, which resulted in my left leg being subsequently amputated in 1959. But it didn’t stop me leading a full and active life, until recently that is”.

Despite being an established prosthesis user, Vernon realised that in recent years, he was suffering more and more falls. He explained, “It would be sod’s law that I would end up on the floor in the most public of places”. He added, “In addition to the embarrassment, I’d often hurt myself in the process. I injured my arms and even my face. My confidence was taking a battering. I was doing less and less and was starting to become reclusive”.

As a keen motorcyclist and active fundraiser and member of his local Masonic Lodge for many years, Vernon wasn’t prepared to accept this as his lot, so made an appointment to see the Consultant at his NHS Centre, to discuss his prosthetic provision. Vernon recalled, “I was advised that a C-Leg would considerably reduce my falls. I said ‘Great, can I have one then please?’ But I was told that due to budget constraints, it wouldn’t be possible”.

Undeterred, Vernon did some research for himself and spoke to the C-Leg manufacturer, Otto Bock. He discovered, to his delight, that another NHS Centre had provided C-legs. Despite the Centre being a considerable distance from his home in Cheadle, he asked his consultant if he could transfer his treatment to there. Vernon recounted, “He said I could. Again, I thought ‘Great!” But he then explained that because the funding would be coming from my local (same) Primary Care Trust, a C-Leg would still not be provided. It was so maddening!”

Frustrated by the whole situation, Vernon turned to Pace Rehabilitation for prosthetic support. For financial assistance, he approached the Masonic Samaritan Fund (MSF), a grant making health and care charity that supports Freemasons and their dependants, as well as non-Masonic medical research charities.

The MSF’s Grant Director and Deputy CEO John McCrohan explained, “For many years we have supported our beneficiaries living with amputations and research projects that hope to improve the support we are able to offer. In Vernon’s circumstance, we were delighted to have been able to fund the Otto Bock C-Leg, which for him is a robust and sustainable way to compensate for the loss of a limb”.

Pace Prosthetist Howard Woolley carried out the clinical assessment of Vernon and his existing prosthetic provision. As he recalls, “There were a number of improvements that could be made, including the introduction of a microprocessor knee. This would provide Vernon with a level of security, safety and confidence that he was currently lacking.”

Clinical activity began, as Vernon recounts, “I felt so well looked after. The attention to detail in producing the prosthetic socket was the ultimate in care and resulted in a very comfortable socket. Essential as any amputee will agree”.

Beneath the diagnostic socket, Howard incorporated a rotator unit, which allows the user to change a shoe, or to don/doff clothing, without the need to remove the prosthesis. The C-Leg (Compact) unit was then carefully aligned and calibrated to Vernon’s requirements.

Using the Bluetooth connection, Howard fine-tuned the settings, as Vernon became more confident with his new provision. A delighted Vernon said, “My NHS consultant was absolutely right, the C-leg is a much safer knee. Now that I finally have one, my confidence is returning!”

For Vernon to maximise his potential from the sophisticated device, Pace Physiotherapist, Carolyn Hirons, identified that intensive physiotherapy and gait training would be required. So, Vernon attended regular physiotherapy sessions, with Carolyn putting him through his paces. As he said, “Although I think she is a sadomasochist, the physiotherapy has been so beneficial. It has meant that my original goal of being able to walk unaided, without a fear of falling, has become a reality.”

Carolyn added, “Not only was his new prosthesis very different to his previous provision, by his own admission, Vernon has acquired some bad habits during his fifty-three years as an amputee”, continuing, “Due to his Polio, his left side is weaker. Consequently, he has developed compensatory movements, but we’ve worked hard to improve his gait and symmetry and he is doing very well indeed.”

Soon after taking delivery of the finished prosthesis, Vernon was delighted to report a regained confidence. He said, “I’ve started to find my feet again, no pun intended! I’ve been able to return to my passion of restoring vintage bikes, with my brother. We’re currently working on a 650cc BSA Gold Star, which is one of fourteen bikes we bought. So we’ll be in the garage for a while!”

As a member of the Mason’s Motorcycle Club, Vernon has returned to regularly dons his leathers & helmet and enjoying the Cheshire countryside aboard his Yamaha sidecar combination.

Vernon summarised his experiences with his recent prosthetic provision, “Without the funding from the Masonic Samaritan Fund, I would be in a wheelchair by now. I can honestly say that thanks to their financial support and to Pace’s outstanding rehabilitation services and care, together they have significantly contributed to the quality of my life, for which I am incredibly grateful.”

A large proportion Pace’s caseload are individuals who have sustained serious limb injury, or limb loss, whom are supported by a litigation claim. If liability can be quickly established and an interim payment obtained to access prompt rehabilitation, then the patient will have the best opportunity to achieve successful outcomes. However, access to funds does not always run smoothly and can become a protracted affair.

Delays in the receipt of rehabilitation services typically results in adverse issues that can significantly increase an individual’s rehabilitation period, as Pace physiotherapist Carolyn Hirons explains, “We often see patients several months, even years, after their accident. During this time they can become physically deconditioned, develop bad habits and adopt negative compensatory movements. Often, their psychological state is adversely affected too”.

In such instances, considerable time and effort is required by Pace’s multi-disciplinary team to stop and reverse this situation as they attempt to restore an individual to as near to their pre-accident state as possible.

Mother of four, Lisa Eagleton, is a patient who has experienced the adverse side of a lengthy legal process. However, more than five years after her accident and following two years of dedication and hard work by herself and her clinicians at Pace, she now finally feels back on track with her life.

Lisa explains, “In February 2007 I was involved in an accident and suffered severe injuries, particularly to my left leg. Despite lengthy attempts to save it, including the use of an Ilizarov frame, the damage and infection was so bad that I underwent a below the knee amputation the following year”.

At this stage, the defendant was still refusing to admit liability for Lisa’s injuries, so Lisa commenced her prosthetic provision with her local provider, but as she explains, it was not a smooth start. “I was experiencing back issues, blistering and sores on my stump. The internal metalwork and pin sites from the Ilizarov frame were causing me real comfort issues that just weren’t being overcome. Basically, I was walking like an old lady and my lifestyle was severely limited!”

Martin James, a partner with Fentons Solicitors LLP, represented Lisa in her pursuit of compensation. “Ever since the incident, the driver’s insurer had refused to admit liability for Lisa’s injuries,” said Martin. “They suggested that she had stepped out from the traffic island in front of the driver and was therefore responsible. Ultimately, we were forced to go to trial to prove this was not the case.”

In May 2011, just a week before the trial, the defendant made an offer to split the liability between the driver and Lisa. Martin explains, “They offered to agree their client was 30% liable for the incident, leaving Lisa with 70% of the responsibility.” He continued, “This was unacceptable. Lisa has been through a horrific ordeal, both with the aftermath of the injury and the subsequent loss of her leg. She has shown tremendous courage and character, returning to study for a new career and also working as a volunteer to help others who have been injured in such a way”.

“As any liability agreement has an impact on what proportion of damages a victim receives, we felt that the defendant’s offer did not reflect the extent of what we believe to be the driver’s negligence. On the second day of the trial, we successfully renegotiated so that Lisa was only held 55% responsible”.

Following the agreement on liability, further negotiations then determined the level of compensation Lisa would receive. Martin explained “We secured interim payments which immediately helped fund a new prosthetic leg for Lisa, and also pay for some of the case management and support worker assistance that she had received since the incident. We then immediately contacted Pace and arranged for Lisa to be assessed.”

Prosthetist Howard Woolley and Carolyn embarked on unravelling nearly five years of complexities, as Howard explains, “Lisa’s rehabilitation certainly wasn’t straight forward. There were big problems with a fluctuating residual limb volume and pain. Lisa has a very busy life and stressful schedule which, combined with an irregular sleep pattern, compounded the problems we were trying to solve”. Howard continues, “Using many diagnostic sockets, and two different types of liner, combined with physiotherapy input, we eventually got her comfortable.”

In addition to some Cognitive Behaviour Therapy, to mitigate her perceived pain levels and stress, Lisa required considerable physiotherapy and deep tissue massage, as Carolyn explains, “Lisa’s posture was poor. She made self-taught abnormal movements around her right hip and experienced considerable pain around her spine and ribs”.

In addition to the physiotherapy she received in clinic, at Pace, Lisa began to actively engage in exercises at home, as she describes, “Gradually I began to build my confidence and to walk properly again”. She continued, “It was a long process, but for the first time in years, instead of experiencing emotional or pain related tiredness, I began to feel physical tiredness, which actually was fantastic and showed that we were making progress”.

Throughout the process, Howard was kept on his toes, as he commented, “Once we got Lisa comfortable, she inevitably did more and pushed the limits, which was great to see and put the pressure on us keep up with her pace”. He continued, “Now that she was beginning to walk properly again, we provided Lisa with a foot with an articulating ankle, which she took very well to. Her walking style changed quite dramatically and it was great to see a return to how I imagine she walked before.”

A very pleased Lisa said, “I can now trot wherever I want to go, on a beach, walk backwards or up a kerb. It works like a dream for me”. As her clinician, Howard was delighted to hear such positive feedback, as he explained, “This is a great result for the whole clinical team. It took a long time, but sometimes that’s what’s needed”.

In keeping with Lisa’s rehabilitation history, her episode of care at Pace has not been inconsiderable, taking almost a year to begin to unpick the acquired complications since her accident. But as she explains, “I have come from having to walk arm in arm with someone at a sedentary pace, to being completely independent”.

Her newfound confidence and independence has enabled her to reengage in her passion for modelling, as she said, “I make the most of what I’ve got; I don’t hide away any more”. Adding, “As part of the Bram Stoker film festival, I’m appearing on the catwalk of the Dracula’s Alternative Fashion Bite in Whitby soon.”

Incredibly, Lisa juggles her busy home life with regular photo shoots, “Recently I’ve done a zombie shoot in a mental asylum, which was a bit weird! I’ve done clothes design, fashion modelling and various charity work.”

Lisa continued,“After my accident my confidence was shot to pieces. I said that nobody’s going to want me, but now I help others! Someone recently said, after seeing my Facebook page, ‘Thanks for sharing and not being embarrassed about your body’. Considering all the difficulties I had to endure over the past years that meant the world to me”.

Following the lengthy legal battle, Lisa’s case finally concluded and she received her settlement, allowing her to look forward to the future. She said, “At the moment I have to dress according to my leg, which is a pain. I plan to work with Howard to get a prosthesis with a high definition silicone cover and one with an adjustable heel height so that I can wear a variety of footwear. There’s no holding me back now!”

Having been an amputee for more than forty years, Vaughan Thompson from Oxford can justifiably be described as an ‘established user’.

Despite his considerable experience, recent issues with socket comfort saw him turn to a private prosthetic provider for the first ever time, as he attended Pace Rehabilitation.

Here is his own account –

“Way back in 1971, I became a below knee amputee following a motorcycle accident when I was 19. I was fitted with an artificial limb by the NHS and quickly adjusted to it, becoming an active walker and climber. Later on I took up competitive cycling, racing at local and international level.

I am proud to say that I have remained active for more than four decades, particularly with my cycling, exclusively using prosthetic legs provided by the NHS.

However, about two years ago I was really struggling, as I was unable to get a prosthetic socket that was comfortable. It certainly was not for the want of trying, or due to a lack of effort by the NHS Centre staff, who made several attempts to produce a comfortable and functional socket, but to no avail.

This period was an incredibly frustrating time for me, as comfortable sockets had been routine up to then and there was no obvious change in my condition, or in the way that the sockets were being manufactured.

It was then that I started looking for an alternative approach. Following a recommendation from another amputee, I visited Pace Rehabilitation, at their Chesham, Bucks clinic. Right from the start, I was impressed by their clinical staff, who carried out a thorough initial assessment of me.

One outcome of the assessment was to be offered a staged approach to my prosthetic provision, which proved invaluable.

Stage one involved a ‘temporary’ leg, with a check socket, just to see if the comfort problems could be solved, before committing to a finished leg. The cost of this stage could be set against the finished leg, if I decided to proceed. I regarded this as very fair and reasonable, as there were no guarantees at this point.

I took the temporary leg home and tested it under ‘real’ conditions, going on long walks and cycle rides, recording my experiences in a diary and with photographs of the stump, to review with the prosthetist, Paul, at my next appointment. This method proved particularly useful, as it clearly highlighted the areas where adjustments were needed to the socket, which was remade accordingly.

This process was repeated several times, demonstrating that my stump was changing shape due to expanding and flexing of residual muscles as I walked more and more, until I was satisfied with the comfort and function of the socket.

By the time Paul and I decided to go ahead with the definitive prosthesis, I was confident that the outcome would be successful. In fact, the whole process is a tribute to the painstaking approach provided by Pace to address the particular problems in my case.

Even as a very established user, I certainly benefitted from the time and attention I received, enabling me to move forward as an amputee in comfort, for which I am eternally grateful”.

In 1989, Pam McGeechan from Rugby in Warwickshire was diagnosed with cancer, resulting in a high transhumeral (above-the-elbow) amputation of her right arm.

Despite this devastating experience, Pam has continued to live a full and active life, although typically only using a cosmetic prosthesis when out and about.

However, after more than 20 years of provision from her local NHS prosthetic facility, Pam decided that it was time to investigate if a more comfortable and aesthetically pleasing prosthesis could be obtained from a private provider.

As Pam explains, “Over the years, my shoulder shape has changed and consequently the arm doesn’t fit nearly as well as it used to, although I’ve never been particularly proud to wear it”. She continues, “I contacted Pace, to see if they could help me and was delighted to be offered an Initial Assessment appointment within a fortnight, where we could discuss my options”.

From the clinical assessment, Pace prosthetist Paul Richardson obtained a clear understanding of Pam’s requirements. As he explains, “Pam identified that she’s is very self-conscious of her uneven shoulder profile. We needed to address that, whilst looking to improve her comfort too”.

Pam promptly received her Initial Assessment report, along with Pace’s recommended prescription. After consulting with husband Anthony, she decided to proceed and returned to Pace two weeks later to be cast for a new socket and commence her prosthetic provision.

As Paul proceeded, he called upon the services of Pace’s expert upper limb technician, Bryan Bradbury. Together they worked closely to produce a device that Pam would feel both comfortable to wear and confident to be seen in public with.

Bryan explains, “We paid particular attention to the shape and appearance of the cosmetic device. I think that the improvements we were able to make were quite significant”.

See before (left) and after (right) images.

There was a brief pause in appointments, whist Pam and Anthony celebrated their wedding anniversary. Yet, just three weeks after her first fitting, Pam was delighted to take delivery of her new cosmetic prosthesis .

A couple of weeks later, Paul received a touching email from Pam, summarising her experience and satisfactory outcome –

“I just want to say a very big thank you for the exceptional care, thoughtfulness and attention to detail you have given me over the past weeks.

From the first meeting, you have listened to what I wanted (I think you were usually there before me!) and delivered it, plus so much more.

Not only have you given me a very comfortable socket and a good looking arm, which makes me less self-conscious, but I now have a wider choice of clothes.

Please give a big thank you to Bryan, for everything he did and to Jayne for her welcoming smile and coffee.

I spent a year wondering if I could justify spending money on myself, but both Anthony and myself both think that what I have come away with is money very well spent.

Pam was subsequently contacted to see if she was happy to be featured in an article. A few weeks passed without reply, until her consent arrived with a note saying – ‘Sorry for the delay, but I’ve been too busy out and about enjoying my newfound comfort!”

http://www.pacerehab.com/wp-content/uploads/2015/02/white-logo.jpg00PaceRehttp://www.pacerehab.com/wp-content/uploads/2015/02/white-logo.jpgPaceRe2015-01-20 15:16:582015-03-31 14:44:56Pam McGeechan - Delighted with her new profile

Robert Upton (64), from Wolverhampton, proudly walked around Pace Rehabilitation’s clinic room, confidently using his recently provided bespoke silicone Symes prosthesis. His restored mobility was in stark contrast to his first appointment a few months previously.

As Robert explains, “When I originally came to Pace I was using a device from my local provider that I found restrictive and quite cumbersome. I couldn’t walk very far in it at all”.

Back in September 2009, whilst working as a fork lift truck driver operator, a piece of machinery fell and crushed Robert’s foot. He was rushed by ambulance for emergency treatment, in an attempt to save his foot. However, after six days and three operations, Robert’s injuries left him with an ankle disarticulation amputation.

He returned home, but was in no position to return to work and worried for his future. As Robert recalls, “It was obvious that I wasn’t going to be able to go back to my job. Also, before my accident, I was an active hill walker, but I felt a million miles away from being able to ever do that again”.

Fortunately, a relative of Robert’s, who works in the legal profession, recommended that he contact Victoria Price, of Price & Slater (Altrincham, Cheshire) to assist him with a litigation claim.

After agreeing to represent Robert, Victoria referred him to specialist rehabilitation providers Pace for a clinical assessment and Medico-Legal report.

As Victoria explains, “I instructed a joint assessment by a prosthetist and physiotherapist, to provide us with a complete picture for Robert’s rehabilitation needs”. She continues, “Armed with their comprehensive report and the other evidence gathered on Robert’s behalf, we were able to agree an out of court settlement, which he was happy to accept”.

The settlement enabled Robert to quickly commence his prosthetic provision. As he explains, “My experience of Pace had been excellent, so I asked them to provide me with my prosthesis”.

In his original report, prosthetist Jamie Gillespie recommended a bespoke silicone prosthesis, with a carbon fibre insole. As Jamie explains, “This solution offers to restore much of Robert’s loss of function, whilst being more discrete and aesthetically pleasing than a more conventional design”.

Robert decided to try the silicone prosthetic option, knowing that if it wasn’t suitable, he could explore a more traditional prosthesis. A home trial on a test device proved successful and so Robert met with silicone specialists to establish colour matches to his own skin tone to apply to the finished device.

When he collected the finished article, Robert was delighted with the outcome. He said “It’s great. As well as being far less bulky and better looking, I walk so much more naturally with it.”

As he summarised, “Thanks to Victoria and Pace’s support, I’ll certainly be showing my toes off when I’m on my summer holidays later this year”. Finally adding, “I hope get back to my hill walking too, something I never dreamt of after my accident!”

Despite being a lower limb amputee, Mayor of Chesham (Bucks) and local Councillor, Derek Lacey (69) continues to lead a very active lifestyle serving his local community, thanks to support from his Primary Care Trust (PCT) and a local independent prosthetic service provider.

Derek explains, “In 1957 I was diagnosed with type I Diabetes, which I managed well for nearly fifty years. However, due to ulceration, I had to undergo a below-the-knee amputation of my left leg in 2003.” He continues, “Despite the issues an amputation brings, I was determined to carry on with life as normally as I could.”
[Mayor Derek Lacey in his formal regalia]

Derek is a well-known character in the local community, serving as a Councillor for the past twenty-five years and having been a stall holder on Chesham’s market for many years.

Since being elected Mayor in 2011, his civic duties have made him even busier. As he explains, “In December I attended more than fifty functions, including eight carol services”. He quipped, “It’s fair to say I know all the words to all the carols!”

Talking about his prosthesis, Derek says, “I may not be running marathons, or climbing mountains, but my commitments mean that I rely heavily on my prosthesis. My duties often require me to be out and about all day long, not to mention many evening functions too.”

Through approval from his local PCT, Derek receives his prosthetic provision from Pace Rehabilitation in his home town. “I was one of their first patients, when Pace opened their Chesham branch in 2009. Since then, they have certainly successfully managed to keep me on my feet!”

Recently Derek took delivery of his spare prosthetic device. As his Prosthetist Jamie Gillespie explains, “With such a busy schedule, Mr Lacey can hardly afford to be without a comfortable prosthesis.” He continues, “Thanks to excellent cooperation from his PCT, he is now in a position where we can make adjustments and alterations to one device, whilst he continues his activities on the other.”

As Derek summarises, “It’s so reassuring to have such good prostheses and support. With the clinic conveniently being on my doorstep, it even allows me to attend appointments in between my engagements. I couldn’t ask for anything more.”

http://www.pacerehab.com/wp-content/uploads/2015/02/white-logo.jpg00PaceRehttp://www.pacerehab.com/wp-content/uploads/2015/02/white-logo.jpgPaceRe2015-01-20 15:15:162015-03-31 15:18:03Derek Lacey - Chesham Mayor on his feet all day